National Provider Identifier [NPI]: |
1780913228 |
Last Name Of The Provider |
NASREEN |
First Name Of The Provider |
NADIA |
Middle Initial Of The Provider |
|
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
F |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
611 W PARK ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
URBANA |
Zip Code Of The Provider |
618012500 |
State Code Of The Provider |
IL |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Internal Medicine |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
21 |
Number Of Services |
831 |
Number Of Medicare Beneficiaries |
304 |
Total Submitted Charge Amount |
219254 |
Total Medicare Allowed Amount |
84553.68 |
Total Medicare Payment Amount |
65630.88 |
Total Medicare Standardized Payment Amount |
67447.4 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
0 |
Number Of Drug Services |
0 |
Number Of Medicare Beneficiaries With Drug Services |
0 |
Total Drug Submitted ChargeAmount |
0 |
Total Drug Medicare AllowedAmount |
0 |
Total Drug Medicare PaymentAmount |
0 |
Total Drug Medicare Standardized Payment Amount |
0 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
21 |
Number Of Medical Services |
831 |
Number Of Medicare Beneficiaries With Medical Services |
304 |
Total Medical Submitted Charge Amount |
219254 |
Total Medical Medicare Allowed Amount |
84553.68 |
Total Medical Medicare Payment Amount |
65630.88 |
Total Medical Medicare Standardized Payment Amount |
67447.4 |
Average Age Of Beneficiaries |
74 |
Number Of Beneficiaries Age Less65 |
59 |
Number Of Beneficiaries Age 65 to 74 |
98 |
Number Of Beneficiaries Age 75 to 84 |
80 |
Number Of Beneficiaries Age Greater 84 |
67 |
Number Of Female Beneficiaries |
180 |
Number Of Male Beneficiaries |
124 |
Number Of Non Hispanic White Beneficiaries |
263 |
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
201 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
103 |
Percent Of With Atrial Fibrillation |
23 |
Percent Of With Alzheimers Disease or Dementia |
27 |
Percent Of With Asthma |
18 |
Percent Of With Cancer |
16 |
Percent Of With Heart Failure |
53 |
Percent Of With Chronic Kidney Disease |
52 |
Percent Of With Chronic Obstructive Pulmonary Disease |
38 |
Percent Of With Depression |
39 |
Percent Of With Diabetes |
44 |
Percent Of With Hyperlipidemia |
73 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
61 |
Percent Of With Osteoporosis |
14 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
52 |
Percent Of With Schizophrenia Other PsychoticDisorders |
13 |
Percent Of With Stroke |
16 |
Average HCC Risk Score Of Beneficiaries |
2.1973 |